CAJ | 학술논문

目的探讨全髋关节置换术后股骨偏距减小与聚乙烯内衬磨损的关系.方法选择90例单侧全髋关节置换术后即刻拍摄双髋正位X线片的病例.利用Coreldraw 12.0等比例重建术后即刻双髋正位X线片,依据股骨偏距减小值(F)分为五组:F＜2 mm组、2≤F≤4 mm组、4＜F≤6 mm组、6＜F≤8 mm组、8＜F≤10 mm组,每组18例;等比例重建终末随访(4～7年,平均5.6年)双髋正位X线片,测量聚乙烯内衬线性磨损量、速度和角度.结果 (1)五组聚乙烯内衬线性磨损量分别为(0.72±0.13) mm、(0.78±0.11) mm、(0.87±0.09) mm、(0.99±0.09) mm、(1.17±0.15) mm,除第1组与第2组外其余组间差异有统计学意义.(2)聚乙烯内衬线性磨损速度分别为(0.132±0.025) mm/年、(0.139±0.019) mm/年、(0.159±0.029) mm/年、(0.183±0.032) mm/年、(0.213±0.023) mm/年,除第1组与第2组外其余组间差异有统计学意义.(3)聚乙烯内衬线性磨损角度分别为5.0°±3.5°、3.2°±3.8°、-4.3°±4.9°、-8.7°±4.1°、-13.0°±4.7°,除第1组与第2组外其余组间差异有统计学意义.结论全髋关节置换术中股骨偏距的重建应尽量达到正常解剖水平,股骨头中心向外上方迁移可能会造成应力分布不均和假体磨损增加.
목적 탐토전관관절치환술후고골편거감소여취을희내츤마손적관계.방법 선택90례단측전관관절치환술후즉각박섭쌍관정위X선편적병례.이용Coreldraw 12.0등비례중건술후즉각쌍관정위X선편,의거고골편거감소치(F)분위오조:F＜2 mm조、2≤F≤4 mm조、4＜F≤6 mm조、6＜F≤8 mm조、8＜F≤10 mm조,매조18례;등비례중건종말수방(4～7년,평균5.6년)쌍관정위X선편,측량취을희내츤선성마손량、속도화각도.결과 (1)오조취을희내츤선성마손량분별위(0.72±0.13) mm、(0.78±0.11) mm、(0.87±0.09) mm、(0.99±0.09) mm、(1.17±0.15) mm,제제1조여제2조외기여조간차이유통계학의의.(2)취을희내츤선성마손속도분별위(0.132±0.025) mm/년、(0.139±0.019) mm/년、(0.159±0.029) mm/년、(0.183±0.032) mm/년、(0.213±0.023) mm/년,제제1조여제2조외기여조간차이유통계학의의.(3)취을희내츤선성마손각도분별위5.0°±3.5°、3.2°±3.8°、-4.3°±4.9°、-8.7°±4.1°、-13.0°±4.7°,제제1조여제2조외기여조간차이유통계학의의.결론 전관관절치환술중고골편거적중건응진량체도정상해부수평,고골두중심향외상방천이가능회조성응력분포불균화가체마손증가.
Objective To investigate relationship between polyethylene wear and decrease of femoral offset after total hip arthroplasty (THA).Methods Ninety patients who had undergone unilateral THA were recruited in this study.Coreldraw 12.0 software was used to measure change of femoral offset on the basis of immediate anteroposterior radiographies of bilateral hip after THA.In the light of the decreasing value of femoral offset (F),all patients were equally into 5 groups:F＜2 mm,2≤F≤4 mm,4＜F≤6 mm,6＜F≤8 mm and 8＜F≤ 10 mm.At final follow up,some parameters about polyethylene wear were measured by using Coreldraw 12.0 software on the basis of anteroposterior radiographies of bilateral hip.Results The linear wear volume was 0.72±0.13 mm in group F＜2 mm,0.78±0.11 mm in group 2≤F≤4 mm,0.87±0.09mm in group 4＜F≤6 mm,0.99±0.09 mm in group 6＜F≤8 mm,and 1.17±0.15 mm in group 8＜F≤10 mm.The linear wear rate was 0.132±0.025 mm/yr in group F＜2 mm,0.139±0.019 mm/yr in group 2≤F≤4 mm,0.159±0.029 mm/yr in group 4＜F≤6 mm,0.183±0.032 mm/yr in group 6＜F≤8 mm,and 0.213±0.023 mm/yrin group 8＜F≤ 10 mm.The linear wear angle was 5.0°±3.5° in group F＜2 mm,3.2°±3.8. in group 2≤F≤4mm,-4.3°±4.9° in group 4＜F≤6 mm,-8.7°±4.1° in group 6＜F≤8 mm,and -13.0°±4.7° in group 8＜F≤ 10mm.For three parameters above,there were significant differences between groups,except between group F＜2 mm and group 2≤F≤4 mm.Conclusion The femoral offset should be restored to its anatomic status in THA to avoide superior lateral displacement of center of the femoral head,which could result in uneven stress distribution and increase polyethylene wear.